IF YOU ARE DIAGNOSED WITH AN INFECTION WHILE IN HOSPITAL.

Some hospitals are now open to receiving and taking on board the opinion and experience of patients. Modern health care workers have a much more holistic approach than in some cases in the past, and the realization that the patient’s beliefs, understanding and participation are important elements in the treatment and outcome of healthcare.
From the service-user’s point of view, it has to be taken on board that there are many thousands of expert, dedicated and hard-working people involved in our health care system, and the experience of many patients is very positive. In our public hospitals, the staff are often working under conditions which are not ideal, and there are shortages of staff and resources which add to the pressure of an already stressful job.

Medical accidents will always happen where human beings are involved. However, it is evident from experience in other countries that most health care acquired infections are avoidable, as it the pain, distress, and sometimes death involved with them. It is also evident that the problem of HCAIs is not going to be solved by one group of those involved in the health care process. It is going to need the co-operation of staff, patients and administrators.

Bearing this in mind, when making complaints, and looking for something to be done about them, it is always advisable to approach the matter initially without aggression, and with an understanding of the position of the staff. If you need to raise a concern or make a complaint in a hospital the first person you should approach is the ward-sister. If you are not satisfied with the response, you may then look for the person in the hospital who is responsible for taking complaints. You will be generally required to fill out some forms, submit them and wait for a response. You may be offered a meeting with the consultant dealing with your case, or the case of the family member involved, and if you are still not satisfied, you will be given the address of the Consumer Affairs Division officer who deals with your area to take the case further. If all this fails there are other avenues open to you, and these will be dealt with at the end of this section. Let’s take the first steps to begin with:
If, while in hospital you are told you, or a family member you are responsible for, has acquired an infection, follow the procedures outlined above to begin with. If you need to have a meeting with the consultant about the case, ask for a microbiologist or the person in charge of infection control to be present.

Here are some questions you may want to ask:

	What, exactly, is the bacterium involved in this infection?
	If it is MRSA, is it a wound, skin, bone, respiratory or blood stream infection?
	If it is VRE, again, where is the infection?
	How might this have happened?
	Can it be treated?
	How?
	What are the implications for my health?
	What do I do when I go home?
	How can I prevent other people getting it?
	Will the hospital contact my GP?

From the evidence of patients who have had to deal with this problem already, sometimes you will get good information, and get listened to with respect, and sometimes you will get attempts to dismiss you. Here are some of the negative reactions people have got, and how you might respond:

	Ah sure! It’s everywhere.
	Response: yes these infections are everywhere, but not to the same extent as they occur in Ireland. In the northern European countries, the incidence of HCAIs is a fraction of what it is here, and people rarely die of them. The system of prevention is much more stringent than it is here.
	You brought it in to the hospital with you.
	Response: This is possible, but nobody knows this unless every patient coming into a hospital is screened and isolated until the results come back. This screening is best practice in infection prevention, and can be done in a matter of hours when the proper equipment is used. Staff should be screened as well. Where coroners have investigated deaths involving HCAIs, they have taken an infection which occurs 48 hours after admission as being hospital acquired.
	It’s nothing to worry about, we all carry it on our bodies.
	Response: We do carry a lot of bacteria on and in our bodies, and we need some of them to survive. A minority of us carry antibiotic resistant bacteria on our skin, in our nostrils and in our bowels, and indeed, we needn’t worry too much as long as we are well. However, if we develop any medical condition which lowers our resistance and damages our immune systems, have to have surgery, or in the case of C.Dif. have to take a lot of antibiotics, then we do have to be worried that the resistant bacteria will cause an infection, and we need to be aware of that.
	Go home, and it will get better.
	Response: If you are merely colonized, leading a healthy life in the open air may dispel the bacteria. However, if you have a compromised immune system or persistent wounds, you still need to take care. If any members of your family have similar conditions, again, you need to make sure the antibiotic bacteria are not passed on to them.

Some patients who have acquired a HCAI and follow the complaints procedure and are given a meeting with the hospital administration, the consultant and the infection control nurse or microbiologist are happy that they have been listened to and their complaints taken on board and are satisfied to leave it at that.
However, there is a significant number of people who go away with their needs unmet. This number includes people who have been so injured by the infection that they have become disabled, lost limbs, lost their livelihoods and have been left with a seriously diminished quality of life. In addition, of course, many people have died as a result of such an infection.

A very frequently asked question is what recourse is open to such complainants?

Here are some answers:
One: Some coroners have stated that if a family member dies, and you consider that a HCAI has been implicated, you should inform the coroner immediately and look for an inquest. The appropriate coroner is the one who covers the district where the death took place. This will help to establish whether the infection was a cause of death. You are also entitled to get the medical records from the hospital involved.
Sitting through an inquest is not a pleasant experience, but people have reported that it has given them satisfaction to know the truth and have it made public.

Two: If you are interested in following up a complaint where you or a family member has acquired an infection in a health care setting, and holding the institution responsible for it you can make a complaint to the Gardai under Section 30 (2) of the 1947 Health Care Act.

This Section of this Act provides the following:


“30
(2) A person having the care of another person and knowing that such other person is a probable source of infection with an infectious disease shall, in addition to the precautions specifically provided for by or under this Part of this Act, take every other reasonable precaution to prevent such other person from infecting others with such disease by his presence or conduct or by means of any article with which he has been in contact.
(3) A person who contravenes subsection (1) or (2) of this section shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding fifty pounds”.
A number of complaints have been made under this act, but so far no prosecutions have followed. However, if the number of complains increases, it may encourage hospital authorities to put proper infection control procedures in place.

Three: The most common means of looking for compensation is to take a legal case for medical negligence, and this path is being followed by many people. One such case has been settled in the case of a young man who got a MRSA infection following surgery. If you want to do this, you will have to consult a solicitor. Look for one who regularly takes such cases and has expertise in the area. Your medical records will be sent to a medico/legal expert to look at and decide if there is a case. There is a cost of almost three thousand euro involved in this, so you must be prepared to lose this amount of money if a decision is made that the case doesn’t have enough merit to go to court. Even if the case is taken to court, it may not be successful, so if you follow this line, there may or may not be satisfaction at the end of it. Your solicitor will discuss this with you.
In Britain, where many of these cases have already been to court and settled, there are solicitors who will work on a ‘no foal no fee’ basis, but there is no evidence that Irish solicitors are will to do this yet. Maybe they will when more cases have been settled, and they are more confident about the outcome.

Four: As part of our campaign, we in SIN are examining the possibility of taking cases under the Supply of Goods and Services Act 1980 when a person has acquired an infection in hospital. We have obtained legal opinion which states that there is no reason why this can’t happen, and we are conducting more research into this possibility. The results of this research will be published on our website www.stopinfecitonsnow.com as will any other relevant information in this regard.